This invention relates to a medical media file management system and method, and more particularly, to an improved system for generating, storing, retrieving and transmitting a plurality of medical data in a digital format, including but not limited to text, charts, still images, animation, graphics, video and audio, derivable from a variety of media image sources, such as computer data base files, hard copy print media, photographs, audio cassettes, video cameras, medical imaging equipment and medical monitoring equipment.
Medical imaging data, as derived from a variety of imaging modalities, is an essential component of health care and is often vital to properly assess a given patient's condition. In this regard, a number of complex imaging modalities are available which can generate digital images, including computerized tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), digital X-ray, ultrasound, nuclear medicine, angiography, and nuclear magnetic resonance (NMR). Other images can be converted into digital form through the use of a film digitizer or scanner for images obtained by more traditional X-ray radiography such as chest X-rays or mammograms, images taken through endoscopes, and physiological monitoring systems including wave patterns recorded in cardiology EKGs and in fetal monitoring. Each of these modalities complement one another depending on the type of diagnosis or monitoring being undertaken, so the systems are often used in conjunction with each other. However, each of these image acquisition devices typically operate as stand-alone devices with relatively small local storage capacity. Each modality is usually designed for the acquisition and subsequent analysis of a specific type of data and the images produced are optimized for a particular medical procedure. Consequently, each modality generates images with different levels of resolution and cannot communicate with another modality's data, resulting in inefficient storage and poor correlation of diagnostic data. These obstacles can prevent the timely and accurate diagnosis of disease. Although it is typically possible to “export” the images from a proprietary radiology (imaging) modality workstation to an industry-standard format such as “Digital Imaging Communications in Medicine” (DICOM) 3.0, several limitations remain as discussed subsequently. In practice, viewing of radiology medical images typically requires a different proprietary “workstation” for each manufacturer and the manufacturer specific Picture Archival and Communications System (PACS) typically extends its use only for the viewing and diagnosis of the radiology-specific images. Even more archaic, and perhaps the more conventional practice is to bundle the various types of imaging data, such as developed X-ray films, ultrasound photographs, and the like, with the actual physical patient file.
Similarly, from a monitoring standpoint, breathing rate, heart rate, and blood-oxygen levels are also essential and can be recorded on an ongoing basis using patient monitoring equipment. Furthermore, monitoring data are generated during EKG tests, treadmill endurance tests, fetal monitoring during labor, sleep research on REM cycles or sleep apnea, and blood sugar level information from diabetes tests. Despite the ability to generate and store such information digitally, in standard practice much of the data is recorded on long strips of paper, which uses significant resources and becomes difficult and bulky to store in the patient files in paper form.
In addition to medical imaging and monitoring data that must be generated and stored, substantial patient data must also typically be collected and retained. Currently, during most hospital check in procedures, a patient may need to fill out numerous forms providing proof of identity and of insurance, as well as forms relating to medical history. While many medical facilities are moving toward computer records of the textual information, there is no efficient way to keep copies of photographs and other media files containing images pertinent to the patient file without actually pulling the paper file from the records office, which can be at a remote location. When a doctor or nurse conducts an interview of the patient, the notes are placed in the file. Although it is not current typical practice, an audio recording of the interview may be useful if there was a simple and efficient means for storing the audio information rather than dealing with loose bulky tapes in the patient file that could inadvertently become erased.
Further problematic is when the patient's primary physician orders tests to monitor the patient's physiological results, which in turn causes the admissions process to be repeated at the monitoring facility. Depending on the duration of the monitoring tests, limited sections of the patient's monitoring response are printed out and marked to highlight areas requiring attention and are folded into a file for the doctor to view at a later time. In cases with sleep studies or recovery from surgery, monitoring may be conducted for several hours or days.
If the patient's primary physician orders an imaging-based test to diagnose or assess disease, the admissions process is likewise repeated at the imaging facility. Typically days after the imaging procedure, the patient's primary physician receives a written report generated by a specialist physician who has interpreted the images but who is unlikely to understand the patient's clinical history and is unaware of any other test results. The patient's primary physician typically does not view the images directly but rather makes a treatment decision based entirely on written reports generated by one or more specialist physicians. The current process raises several limitations on efficient diagnosis and treatment of patients. The primary physician does not see the images unless they are printed to film or the doctor travels to another department and makes a request. Each proprietary modality workstation at a separate location requires training in how to use the software to view the images, and images from the same patient but different modalities cannot be viewed side-by-side, even using proprietary workstations. The primary physician cannot show the patient his/her images in the physician's office while explaining the diagnosis; and the patient cannot transport his/her images to another physician's office for a second opinion.
As if such practices were not already burdensome, recently implemented legislation has made the ability for hospitals and physicians to generate and assess patient information, and in particular, medical imaging data even more difficult. Specifically, The Health Insurance Portability and Accountability Act (HIPAA) of 1996, signed into law on Aug. 21, 1996, sets forth numerous regulations related to the practice of medicine, particularly with respect to the handling of healthcare-related information, that are intended to reduce the administrative costs of healthcare. Essentially, HIPAA sets forth provisions related to the development and implementation of standardized electronic transactions and the implementation of privacy and security procedures to insure confidentiality and prevent the misuse of patient information. With respect to the former, namely, standardized transactions, the same are to be used no later than Oct. 16, 2003.
Among the many requirements set forth in HIPAA is that any medical practice that electronically sends or receives certain transactions must send and receive them in a standard format. Such transactions expressly include claims, remittance and payment advice, claims status, enrollment and dis-enrollment in a health plan, premium payments, eligibility inquiries and responses, referral certifications and authorization, coordination of benefits, first reports of injury, and claims attachments. In this regard, it is contemplated that a medical practice will be able to submit a claim for a patient, irrespective of the payor involved (e.g., insurance company, health maintenance organization, etc.). As a result, it is contemplated that all transactions will be standardized in nature, which will include the uniform use of codes typically associated with conventional billing practices, such as diagnosis codes (i.e., ICD-9-CM), procedure/service codes (CPT-4), drug codes (NDC), and other service codes (HCPCS), among others.
With respect to imaging data, however, particularly when generated and stored in physical patient files and not otherwise kept in a format that can facilitate the electronic transmission of data, is operative to defeat the entire legislative purpose behind HIPAA. Furthermore, it is practically impossible and cost-prohibitive to duplicate Radiology Film Storage when the Films are not in a Digital Format, thus making the task of HIPAA required back-ups and disaster recovery meaningless. Accordingly, there is a substantial need in the art for a medical media file management system and method that is operative to not only facilitate the collection, storage, retrieval and transmission of medical imaging data capable of being generated from a wide variety of imaging modalities, but further is operative to facilitate the collection, storage, retrieval and transmission of other types of patient data, such as digital photographs, scanned in images of patient identification and insurance information, and recorded audio (e.g., transcription) files, to thus enable all such information to be retained in an efficient digital format. There is further a need for such a system and method that can be readily integrated with virtually all types of medical imaging modalities, as well as conventional devices, such as digital cameras, that can enable all information derived thereby to be stored and retained in a digitized format. There is still likewise a need in the art for such a system and method that can be incorporated as part of an existing electronic medical record (EMR) which can thus greatly reduce the amount of physical storage associated with storing personal files, as well as facilitate the handling and exchange of patient information and transactions related thereto, especially in compliance with HIPAA. There is still further a need in the art for such a system and method that can be constructed utilizing existing technology, is of low cost, is exceptionally efficient and can be integrated into virtually all types of existing medical and hospital practices and procedures.